Sunday, September 27, 2009

FAQs

How will you make a living?
I can go without making a living for a couple years, maybe 1000 days; this is too important a time to worry about my retirement account anyway. I Appreciate your concern for my finances, but frankly i'm more concerned with the finances of all potential patients. Because, health care expenses can crush you. My financial wealth is worth less because of bloated health care costs and they help make it impractical to open your own business. Fear of health care costs restricts our social freedoms severely because you are bound tightly to your job for the protection that health insurance affords.

What about malpractice insurance?
I can't afford it; I will continue to do my best but will make errors like anyone else. Since I won't have malpractice insurance, all a prosecuting at tourney would have to gain money wise from me are my meager assets.

What about medical records?
I won't be storing your medical records; if you want a note generated for your records and or your PCP's records then i'll provide a note for you to do with what you wish. I don't think I'll have access to your electronic medical records which further restricts how we'll manage medicines. We'll have plenty of time to work around any problems and gather records when needed. It'll take some getting used to.


Can you order tests?
I think so; but we'll have to have the results sent to your PCP and have you get a copy?

Do you have an DEA license?
yes and I don't believe that will be affected by leaving the clinic setting

Do you have a state medical license?
yes

Are you board certified?
yes but I won't be maintaining that since it's only an insurance billing requirement; CMEs or continuing medical education has traditionally been dominated by pharmaceutical sales reps

How's this going to work?
Well you'll sign on to yahoo instant messenger and open a window and talk to me and we'll go from there.

Participate a little or as much as you'd like; there are no hidden charges and no obligations to purchase anything

More later as the questions roll in

Mammography for breast cancer screening

Ok this is not an endorsement for or against screening mammograms. This is just some information that's important to consider before you decide if mammograms for screening is right for you.

Your risk factors may be high enough that mammography screening makes a lot of sense.

The decision should be based on a good understanding of the risks and benefits.

Here's a rough outline of those risks and benefits:

If 1000 women between the ages of 50-74 get mammograms yearly for 10 years

1 will have her life saved by mammography screening
between 2-10 will be diagnosed unnecessarily with breast cancer
between 10-15 will be diagnosed earlier but it won't affect the prognosis
100 to 500 will have at least one false positive test requiring more testing or biopsy

http://www.bmj.com/cgi/content/abstract/339/jul09_1/b2587?q=w_latest_topic
the british medical journal saying is a little differently


http://www.insidermedicine.ca/archives/VIDEO_One_in_Three_Breast_Cancers_Found_by_Screening_Mammography_May_Be_Harmless_Interview_with_Dr_Karsten_Jorgensen_MD_Nordic_Cochrane_Centre_3638.aspx


http://www.bmj.com/cgi/content/abstract/312/7026/273
talks about false positives ; each mammography center has a "recall" rate. The % of mammograms that are followed by "let's repeat the Xray" results
Our local center in Yakima, Ohana has a recall rate. I don't know the % for sure, but i'm sure we could find out.

http://www.scientificamerican.com/article.cfm?id=knowing-your-chances
this talks about one of the books of required reading if you want to make informed decisions about cancer screening tests